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The Controversy Over Dr. Atkins’ Health

By Neal D. Barnard, M.D.

The Atkins diet phenomenon has spread like a virus across North America, Europe, and elsewhere. It has convinced millions of people to buy into two dangerous notions: that avoiding carbohydrates is the key to weight loss and that high-fat, high-cholesterol foods pose essentially no risk.

Serious health problems and deaths have occurred in individuals following the diet. For example, the Southern Medical Journal reported the case of a sixteen-year-old Missouri girl who died while following a low-carbohydrate diet. In the report, her physicians described the ways the diet may have contributed to the disordered cardiac rhythm that killed her. Jody Gorran of Delray Beach, Fla., went on the diet, only to find that his cholesterol level skyrocketed. He developed chest pain and needed urgent heart surgery. And in 2001, the American Heart Association issued a warning that low-carbohydrate diets are likely to contribute to heart and kidney disease.

The principal spokesperson for the diet was Robert C. Atkins, the controversial doctor whose 1972 book described how carbohydrate avoidance cured his own weight problem. In subsequent years and even after his death, the Atkins organization has used details of Dr. Atkins’ health condition as a key part of its marketing strategy. As the Wall Street Journal put it, “Throughout his life, Dr. Atkins was the public face of the eating plan he espoused and often spoke publicly about his own eating habits and health.”

Dr. Atkins discussed his medical history in media interviews, and Atkins Nutritionals posted details of his cardiac history on its Web site. In particular, it described his cardiomyopathy—a diseased heart muscle that he attributed to a viral infection—as well as a cardiac arrest that apparently occurred as a result.

The Atkins site also described tests of Dr. Atkins’ coronary arteries, saying he had an angiogram at Columbia Presbyterian Hospital in April 2001 that showed normal coronary arteries.

Why was the Atkins company providing so much personal detail about Dr. Atkins’ medical status? Because doctors and health organizations have cautioned Atkins dieters that high-fat, high-cholesterol foods can lead to heart disease. In the intense marketing of commercial diet products, Atkins and his company have tried to convince dieters to set those concerns aside.

In a statement on April 25, 2002, Dr. Atkins’ personal physician said this about Dr. Atkins: “Clearly, his own nutritional protocols have left him, at the age of 71, with an extraordinarily healthy cardiovascular system.” In other words, not only was Dr. Atkins in great health, dieters were told, but his diet—which he had followed for decades—could take the credit for it.

Recently, a physician sent PCRM a copy of some medical examiner’s notes related to Dr. Atkins’ death. This physician, who is not a member of PCRM, obtained the notes from the New York City Medical Examiner’s Office. The notes were not from a hospital chart or an autopsy—Mrs. Atkins had apparently declined to have an autopsy done. The medical examiner had simply noted Atkins’ weight at the time of his death, inspected his external surfaces, and noted a few aspects of his history. However, some notes suggested that Dr. Atkins had heart problems that went beyond the viral cardiomyopathy to which he had admitted.

Reporters picked up on the story; they wondered whether the Atkins organization had distorted Atkins’ health profile to make the diet appear safe. Although PCRM had not requested or received the report from the medical examiner, we became the principal media contact about it.

Then, on Tuesday, February 10, 2004, Mrs. Atkins released a statement clarifying details about her husband’s health. She confirmed that, in fact, he did have coronary artery disease. In particular, she said that Dr. Atkins “did have some progression of his coronary artery disease in the last three years of his life including some new blockage of a secondary artery that was remedied during this admission….” Artery blockages of this type are typically caused by high-fat, high-cholesterol diets, smoking, and other lifestyle factors.

It must be emphasized that it is always a matter of concern when elements of an individual’s medical history become a matter for public discussion. In this case, the Atkins company—and Dr. Atkins himself—made a major issue of his health and exploited his seemingly robust cardiac status as a means of allaying fears about the fatty diet he espoused.

Many health authorities have been shocked and greatly troubled by the spread of the Atkins phenomenon. People around the world have been lulled into complacency about cardiovascular health. Disregarding cautions about saturated fat and cholesterol, they are digging into steaks, pork chops, and cheese and shying away from fruits, legumes, and whole grains, with little regard for their long-term health. It is disturbing that Dr. Atkins may have been less than honest with the public in such a way as to spread a message that many doctors and health organizations say is dangerous.

In the public discussion of this issue, we wish to underscore that no hospital or clinical medical records were obtained, discussed, or publicized and that no autopsy was performed on Dr. Atkins. The new revelations consist only of brief notes from an external inspection of Atkins’ body by the medical examiner, followed by new revelations by his widow. PCRM’s only goal in discussing these issues is to curtail a major public health threat.

If the new revelations about Dr. Atkins’ cardiac problems end the charade that fatty, high-cholesterol foods can give us an “extraordinarily healthy cardiovascular system” and have no health consequences—and if the emergence of the truth can prevent further deaths and illnesses—then the public health may at last be served.

Buyer Beware

The low-carb craze has led to new and peculiar products such as low-carb beer and breadless “sandwiches.” PCRM’s nutrition department took a close look at new restaurant offerings labeled “Atkins-friendly” or “low-carb,” finding that, in terms of fat content, fiber content, and calories, most entrées are a nutritional nightmare. Below are the top ten worst offenders based on these criteria.